45D2119704 CLIA NUMBER - WALMART PHARMACY 10-3482

Laboratory Demographics

  • CLIA Code: 45D2119704
  • Facility Name: WALMART PHARMACY 10-3482
  • Facility Address: 425 COIT ROAD
    PLANO, TX
    ZIP 75075
  • Facility Phone: 972 599-9066
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JULIUS F. AGWE
  • NPI Number: 1386661429
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2119704
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3482
Street 425 COIT ROAD
City PLANO
State TX
ZIP 75075
Phone 972 599-9066
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Pharmacy
Lab Director JULIUS F. AGWE

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This page was last updated on: 9/29/2025